Abstract
Introduction Research related to the impact of maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on fetuses and neonates remains limited. The majority of previous studies have focused on immediate outcomes. We conducted this prospective cohort study to evaluate the effect of in utero SARS-CoV-2 exposure on the growth and neurodevelopment of infants, considering the scarcity of long-term follow-up studies in the literature. Primary Objective The primary objective of the study was to compare neurodevelopment and growth up to the age of 1 year among coronavirus disease COVID-positive and COVID-negative neonates born to COVID-positive mothers. Secondary Objectives The secondary objectives of the study were to assess the status of exclusive breastfeeding in infants at the age of 6 months and to assess the risks of vertical and horizontal transmission of COVID-19 infection. Methods We included live neonates with gestational age >28 weeks born to pregnant women who tested positive for COVID-19 by reverse transcription polymerase chain reaction and delivered at the institute in this prospective observational cohort study. Details related to delivery and neonatal profile, including the neonatal COVID status were collected. Neonates were followed up at 6 months and 1 year for physical growth profile and neurodevelopmental profile using World Health Organization growth charts and the Baroda Development screening test (BDST). Results A total of 6 SARS-CoV-2-positive and 82 SARS-CoV-2-negative neonates were followed until the age of 1 year. There was no statistically significant difference between the SARS-CoV-2-positive and SARS-CoV-2-negative cohorts concerning gestational age (P-value 0.300), birth weight (P-value 0.988), and neonatal intensive care unit admission (P-value 0.288). Approximately 65.9 and 45.4% of infants were still exclusively breastfeeding at the ages of 6 months and 1 year, respectively. No difference was observed in wasting (P-value 0.393) and stunting at the ages of 6 months (P-value 0.656) and 1 year between the two cohorts. Furthermore, no significant difference was observed in neurodevelopmental status at 6 months (P value for BDST score 0.236; P value for developmental quotient (DQ) 0.446) and 1 year (P value for BDST score 0.635; P value for DQ 0.666) between the two groups. Conclusion Our study generated evidence that in utero exposure to SARS-CoV-2 infection does not seem to affect the growth and neurodevelopment of neonates born to SARS-CoV-2-positive mothers; however, further studies including nonexposed controls, are warranted to support our findings. Furthermore, the benefits of rooming-in and breastfeeding on the neurodevelopment and physical growth of infants far outweigh the minimal risk of horizontal transmission.
Published Version
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